Preparing for Labour? The Process & Toolkit. What every midwife want you to know.

7 min read

BY MONIQUE MAITLAND| Registered Midwife & Nurse | Childbirth Educator | Podcast Host 

1. PREPARATION

After months of patiently waiting it’s time to finally meet your baby. Here are some of the top tips that all midwives want you to know about preparing for labour and birth.

As a midwife, I have provided care and assistance to many women throughout their pregnancy, birth and postpartum phases. Through my experience, I have witnessed the significant advantages of adequately preparing for childbirth. Knowledge is power.

Having knowledge about what you can expect when in labour prior to giving birth allows you to better understand the physiological process of birth. I’ve seen many women view childbirth as ‘scary’ due to the fear of the unknown. Often the fear can be transformed into feelings of empowerment and excitement just by having a deeper understanding of what to expect in labour.

There is a raft of emotions that come with the different stages of labour. For example, during transition (dilation of between 8-10cm), it is completely normal to become restless and experience a change in mindset and think “I can no longer do this!”. Or understanding how we need to have regular and strong contractions to birth a baby.

Gaining an understanding of potential interventions you may face, their benefits and limitations will also help you and your birth team make calmer and more informed decisions for the birthing experience you deserve.

There are a number of ways to prepare and educate yourself for childbirth

• Childbirth classes
  • these can be an in person group class, private class or online.
  • childbirth education classes are facilitated by experts within the profession so you can be assured that the education you are receiving is up to date & evidence based.
  • it is best to research and find an educator that is the best for you as some educators may not be a registered midwife or currently practicing within the birthing space. For more information of birthing classes and what to look for click here (link to other Q&A) 

• Podcasts
  • Midwifery based podcasts and medical professionals are recommended for the most fact based information. Here are some podcast recommendations:
  • Middee (My podcast)
  • The Midwives Cauldron
  • VBAC Birth stories
  • Growing
  • The Moment
  • Baby Baking + Kid Raising
  • Pregnancy Uncut

• Books & other resources
• • Books: Some recomemeded books are:
  • The Complete Australian Guide to pregnancy & birth - Jodi Wilson, Sophie Walker
  • Birth after Caesarean - Hazel Keedle
  • Reclaiming Childbirth as a Rite of Passage - Rachel Reed

• Hospital literature:
• Most Hospitals will provide their own fact sheets which are created from the latest evidence. These are a great go to prior to heading to google as you can be assured they are providing accurate education.

• Instagram:
  • There are so many great instagrams out there run by midwives that provide free education. These accounts are run by Midwives who have a strong passion for supporting women throughout their labour & birth. It is also important to follow the accounts which best align with your own beliefs & values.

 

2. LABOUR

It’s a marathon not a sprint. Labour is the very last component of this “marathon” which you’ve been running for the past 9 months. Just like a marathon, labour and birth takes time.

Labour is diagnosed in the presence of regular, strong contractions with full effacement of the cervix (when your cervix is totally thinned out) and where the cervical dilation is ≥5cm.

I often get asked by many women “how long will labour take?”. I always say I would be a millionaire if I could answer that. As a midwife I know that every woman’s labour is different. 

The progression of labour can be influenced by multiple factors. We refer to these as the four P’s:

1. Passage (Pelvis) - Taking into consideration the shape, size, and movement of your pelvis.
2. Passenger (Baby) - Refers to your baby and this little one really must come to the party.The descent of your baby is encouraged by:
   • Fetal size: Is your fetus a size that can fit through your pelvis?
   • Fetal lie: Are they facing the correct way within the pelvis? The optimal position is a direct occiput anterior baby.
3. Presentation: What is the presenting part? e.g., vertex, face, foot, buttocks.
   • Is there good flexion of the fetal head to create the smallest diameter to be birthed vaginally?
4. Psyche: This refers to the mother's mental state. Taking into consideration her energy levels and feelings..

So, what is the normal progress of labour?

Our research suggests that when a woman has strong, regular uterine contractions, the progress of cervical dilatation is considered normal when dilatation is ≥ 2cm in 4 hours.

For a woman diagnosed in labour at 5cm it is suggested to allow up to 12 hours for a first-time mum and 10 hours for multiparous women (previously had a baby). However, these timeframes may vary taking if diagnosis has been made at a greater dilatation.

The pushing phase (active second stage) of birth also takes time. You can expect to allow up to 2 hours for a first time Mum and an hour for a multiparous woman to birth her baby.

My midwife advice for labour:

Just like running a marathon, during labour there will be parts where you get into a good rhythm and feel as though you could run for miles. Your supporters (partner, friend, family, midwife) are providing you with all the fuel and encouragement you need to keep going.

However, there can be times which feel tougher than others - like running uphill.  That’s okay but it’s important that during these times, you recognise that this feeling is only temporary. You are stronger and more powerful than you think. You can get through it.

The moral of the story.

Your baby’s descent, cervical dilation and the birth of your baby takes time. This is all normal. Be patient. Surrender to this moment. Remember to breathe, and maintain a positive mindset, because before you know it you will be 100m from the finish line with your baby on your chest experiencing the most incredible adrenaline and oxytocin high. You can do it Mama!

3. THE LABOUR TOOLKIT

 

Preparing your labour tool kit prior to the big day is essential. Why?

Because knowing what tools you want to utilise during labour and how to use them is going to help you both physically and mentally.

Plus, it's great for your support person to build their own tool kit too! Your tool kit should include strategies for both labour at home and when in hospital. From tools such as breathing techniques, relaxation strategies, types of massage, a tens machine + so -much more.

It may even be as simple as having a diffuser going within the birthing space or hanging up positive affirmations. By having multiple tools in your tool kit, this means you can use a variety of strategies throughout your entire labour and birth to find what works best for you.

As a midwife here’s some suggestions of what I would include within my labour tool kit:

• Music: Create a playlist of some of your favourite songs to boost your spirits both at home and in hospital.
• TENS machine: great for both the early and active labour. TENS machines help to trick those pain receptors and instead release endorphins decreasing our perception of pain.
• Affirmations: Surround yourself with positive affirmations and things to inspire you. This may as simple as a passage of text, or a baby onesie which you have always envisioned your baby to wear, items for good luck or photos of loved ones. Positive affirmations are great during those tough times when you need some extra motivation to keep on going.
• Water Immersion: Utilise the shower or bath to help promote relaxation and help manage contractions. Water immersion is a fantastic pain relief option!
• Gravity: By using gravity throughout labour this allows your baby to move down the pelvic canal. Staying upright in labour has been shown to decrease labour length by approximately 1 hour. A birth ball in labour is a great way to stay upright.

Once again, preparation is the key. Educating yourself and your support team prior to giving birth is essential when it comes to preparing for labour. By having knowledge about what to expect when in labour, what tools you can use and how you can best advocate for yourself is what is going to set you up for a more empowering and positive birthing experience.

4. MY TAKE HOME NOTES

• Do some form of childbirth education. Either sign up to a childbirth education class, listen to midwifery-based podcasts or read pregnancy related books.
• It’s a marathon not a sprint. Remember that labour and birth take time. Surrender to this moment and have trust in your own body’s ability to birth. You are stronger than you think!
• Build your labour tool kit!

You’ve got this Mama!

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Monique Maitland is an enthusiastic Registered Midwife/Nurse from Melbourne, founder of The Middee Society & host of the podcast ‘Middee’.